Plasma therapy offers alternative therapy for injuries

Tuesday

Jun 22, 2010 at 12:01 AMJun 22, 2010 at 9:21 PM

Runner Katie Bodenstedt, 17, had to stop competing this year because of knee problems. More than a decade of running had taken its toll on her right knee. She’s endured cortisone injections, arthroscopic surgery and two years of physical therapy. None of it seemed to work. But she’s planning to compete next season, thanks to a treatment that puts her own blood to work for her.

Sue Van Fleet

More than a decade of running had taken its toll on Katie Bodenstedt’s right knee.

Bodenstedt, 17, runs cross country and track for St. Ursula Academy in Toledo, but wasn’t able to compete this year because of her knee problems. She’s endured cortisone injections, arthroscopic surgery and two years of physical therapy. None of it seemed to work.

“I’d been running cross country since kindergarten, so it was a long time coming,” she says. “I went from running 5K races to not being able to run a mile.”

But she’s planning to compete next season, thanks to a treatment that puts her own blood to work for her.

In platelet-rich plasma therapy, blood is first taken from the patient and spun in a centrifuge. The process separates out plasma that’s rich with platelets containing proteins known as growth factors, which promote cell growth. These platelets are injected into the site of the injury. Most conditions require from one to three injections, although more are sometimes needed.

The treatment works for a variety of conditions involving tendons and ligaments, such as tennis elbow, plantar fasciitis, small rotator cuff tears, Achilles tendinitis, golfer’s elbow and patellar tendinitis, commonly known as jumper’s knee, according to Ronda Winans, a physical therapist and the director of sports care for the ProMedica Health System.

Using platelet-rich plasma therapy for these kinds of conditions is fairly new, which is why some research seems to indicate mixed results for the procedure, Winans says.

“There hasn’t been enough long-term research to validate it,” she says, “but what we see clinically is that it’s benefiting the patients.”

In fact, patients can often see the results themselves, since ultrasound is typically used to guide the injections. “They can see the ugly-looking tissue, and then down the road they can see the change,” Winans says.

Led by Dr. Roger Kruse, who practices with the Sports Care and Wildwood Family Practice in Toledo, ProMedica has been offering the treatment for about a year.

His success rate with the treatment is about 80 percent, Kruse says, but it’s not for everyone.

“You have to choose the right patients for it,” he says. “It’s not for every injury, and I think that’s why they get mixed reports, because they use it on the wrong medical problems.”

The best patients, he says, are those who want to avoid surgery and have conditions involving tendon or ligament soft tissue that have not responded to other treatments.

“We’ve had great success, and I’m very excited about it,” Kruse says. “I think over the next two years it’s going to get bigger and bigger.”

Paramount will pay for the treatment with the right diagnosis, Kruse says, but in general, insurance companies aren’t yet supporting the treatment.

“Once we get more of a medical evidence base behind it, I believe they will,” he says. “It’s cheaper than surgery or continued physical therapy, and I think that as soon as insurance companies understand that, they will OK it.”

Bodenstedt was an ideal candidate for platelet-rich plasma therapy because everything else she had tried had failed. In addition to physical therapy and cortisone injections, she had had surgery to remove plica — fibrous tissue — from her right knee, but it didn’t eliminate the pain.

“They did an ultrasound and found a big, black hole right above my kneecap where the tendon stopped,” she says. When the large deficit in her quadriceps tendon was discovered, platelet-rich plasma therapy was suggested as a possible treatment option. “I tried it because we had pretty much exhausted every other option,” Bodenstedt says.

Her condition improved after her first treatment in March, and another treatment was scheduled for April. The second ultrasound showed that most of the tendon had grown back, she says.

She and Kruse were considering a third treatment, but meanwhile, she’s running again. She’s back to conditioning for cross country and can again run a 5K, although she’s not up to racing yet.